Laryngoscopy

Laryngoscopy is a procedure to look at the back of your nose, throat and voice box (larynx).

You’ll meet the surgeon who’s going to do your procedure to discuss your care. It might be different from what we describe here because it will be designed to meet your individual needs.

About laryngoscopy

A laryngoscopy allows your surgeon to look at your throat and find out the cause of any problems. These might be problems with your voice, difficulties swallowing, or throat or ear pain. They can also check if you have any injuries in your throat, narrowing of your throat (strictures), or a blocked airway.

There are two ways to do a laryngoscopy.

In a flexible laryngoscopy, your surgeon uses a thin, flexible, fibre-optic tube with a light and a camera lens at the end called a laryngoscope. They’ll pass the laryngoscope through your nose to the back of your mouth. It’s used in check-ups and to diagnose health problems.

Rigid laryngoscopy uses specially designed tubes that your surgeon will pass through your mouth. They can then pass instruments through the tubes to remove any blockages in your throat. Or they can take a sample of tissue (biopsy), remove polyps (growths) from your vocal cords, or give you laser treatment.

An ear, nose and throat (ENT) surgeon will usually do both flexible and rigid laryngoscopy procedures.

Preparing for a laryngoscopy

Your surgeon will spend some time explaining how to prepare for your procedure.

You can have a flexible laryngoscopy as an out-patient procedure under local anaesthesia, which is usually in the form of a nasal spray. This will reduce the sensation of the laryngoscope passing through your nose and will stop you gagging when the tube goes down your throat.

Rigid laryngoscopy is done as a day-case procedure in hospital under general anaesthesia, which means you’ll be asleep during it. An anaesthetic can make you sick so it's important that you don't eat or drink anything for six hours before it. You might be able to have some water up to a couple of hours before – follow your anaesthetist or surgeon's advice. If you have any questions, just ask.

If you’re having rigid laryngoscopy, there’ll be some pressure on your top teeth from the laryngoscope. Your hospital might give you a gum shield to wear to protect them. If you have implants, caps, crowns or any other dental work, it‘s important to let your surgeon and anaesthetist know.

Being fully informed will help you feel more at ease and will allow you to give your consent for the laryngoscopy to go ahead. You may be asked to do this by signing a consent form. If you’re not sure you want to have the laryngoscopy, you can take more time to decide. Your surgeon won’t carry out the procedure until you understand and agree with what’s going to happen.

What happens during a laryngoscopy?

Flexible laryngoscopy

This usually takes about 10 minutes and you’ll sit down while you have it. First, your surgeon will spray the local anaesthetic into your nose. It has an unpleasant taste, and might make you cough. The numbing effect will last for about half an hour.

Your surgeon will then pass the laryngoscope through your nose and into the back of your mouth. To help your surgeon to see your entire throat, they might ask you to:

stick your tongue out as far as possible

take some deep breaths through your nose

make some sounds so they can see your vocal chords

The camera lens on the end of the laryngoscope will send pictures from the inside of your throat to a monitor.

Rigid laryngoscopy

This usually takes about half an hour and you’ll need to lie on your back while you’re having it done. Before you lie down, remove any dentures or dental plates, contact lenses, glasses and jewellery. Once the general anaesthetic has taken effect, your surgeon will carefully pass the laryngoscope down your throat. They might look directly into the laryngoscope or at images on a monitor.

If necessary, your surgeon will take a biopsy, which is a sample of tissue. They’ll pass instruments through the laryngoscope to take the sample. Your surgeon will send this to a laboratory to see what type of cells they are, and if they’re cancerous or not.

What to expect afterwards

If you have general anaesthesia, you’ll need to rest until the effects of the anaesthetic have worn off. You’ll then be able to go home when you feel ready, but ask a friend or relative to drive you home. It’s a good idea for them to stay with you for the first 24 hours too.

If you have a local anaesthetic, you can go home straightaway. It may take around half an hour before the feeling comes back into your throat. Don't drink or eat anything until the local anaesthetic has worn off. If you’ve had a rigid laryngoscopy, don’t eat or drink anything for about two hours afterwards or sometimes even longer – wait until you can swallow normally.

If you have a biopsy, your results will be ready several days later and will usually be sent to the surgeon who recommended the laryngoscopy. At the hospital, your surgeon may discuss other findings from the laryngoscopy with you before you leave. Or you may be given a date for a follow-up appointment.

Recovering from a laryngoscopy

You're likely to have a sore throat after the laryngoscopy. This can last for a day or two after a rigid laryngoscopy. If you need pain relief, you can take over-the-counter medicines, such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Having a general anaesthetic can really take it out of you. You might find that you're not so co-ordinated or that it's difficult to think clearly. This should pass within 24 hours. In the meantime, don't drive, drink alcohol, operate machinery or sign anything important.

Most people don’t have any problems after a laryngoscopy, but seek urgent medical attention if:

your voice changes

you get any lumps in your neck

you have earache

your face hurts

Side-effects of a laryngoscopy

Side-effects are the unwanted but mostly temporary effects of a procedure. Side-effects of a laryngoscopy may include:

a sore throat

difficulty swallowing

changes to your voice, especially if your surgeon takes a biopsy

a stiff neck

bleeding – you might see a bit of blood in your phlegm

a nosebleed

Complications of a laryngoscopy

This is when problems occur during or after the procedure. Complications of a laryngoscopy can include:

difficulty breathing – this might be because of having the laryngoscope in your throat or because of the effects of the general anaesthesia

damage to your airway or throat lining – particularly if you have a biopsy taken

Frequently asked questions

You can eat and drink as soon as you feel ready and the numbness caused by any local anaesthetic has worn off.

More information

You might have a sore throat for a few hours after having a laryngoscopy. So you may want to stick to soft foods or liquids until you feel better.

If you’ve had a local anaesthetic for a flexible laryngoscopy, wait until this has worn off before you eat. This usually takes about half an hour.

If you’ve had a rigid laryngoscopy, and biopsies taken, your surgeon may ask you to not eat or drink anything for a couple of hours after your procedure. But you will be able to have something later the same day.

Your voice may be hoarse for a short while after the procedure but it's unlikely you’ll have any long-term problems.

More information

Your voice is made of tones, which are produced by your larynx. The different sounds you make are formed by your tongue, teeth, lips and nose. Immediately after a laryngoscopy, especially if you had biopsies taken, you may have some swelling in your throat. This can affect the quality of your voice. It might sound hoarse until the swelling goes down.

Your surgeon may suggest that you rest your voice after having a laryngoscopy. This could be just for a day or two, or could be up to two weeks. Ask your surgeon what you should do.

An ENT surgeon is trained in the surgical and medical treatment of conditions that affect the ears, nose, throat, head and neck.

More information

ENT surgeons treat problems with hearing and balance, sinus infections, snoring and voice and swallowing disorders. They also deal with throat and neck cancers.

ENT surgeons are usually called Mr or Mrs, Ms or Miss rather than Dr and will have Fellow of the Royal College of Surgeons (FRCS) after their name. The Royal College of Surgeons is responsible for the training and examination of surgeons, and supports surgical research in the UK.

If you think you need advice or treatment from an ENT surgeon, contact your GP. They can recommend a reputable surgeon and give advice about how to choose where to be treated.

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